Background Penetrating vertebral artery injuries (VAIs) are rare, difficult to diagnose, and pose a challenge to surgeons, given their complex anatomy and difficult surgical exposure. Due to the rarity of these injuries, few surgeons and trauma centers have developed a…
Carotid arterial injuries are the most difficult and certainly the most immediate life-threatening injuries found in penetrating neck trauma. Their propensity to bleed actively and potentially occlude the airway makes surgical intervention very challenging. Their potential for causing fatal neurologic…
The diagnosis of vascular trauma is usually not a problem, as most injuries manifest overt blood loss, shock, or loss of critical pulses. However, in certain instances, the lesion may not be recognized initially, only to manifest itself later by…
From Egyptian, Greek, and Roman battlefields centuries ago, extremity vascular injuries were identified and treated. Subsequently, knowledge regarding the management of vascular trauma has also been gained from more modern military conflicts. Napoleon’s surgeon Larrey was an expert with rapid…
Introduction to combat torso trauma In the modern era, combat trauma care frequently involves the management of major torso injuries that would have been rapidly fatal in previous conflicts. In addition to the severe wounds and altered physiology, surgical teams…
Current critical care supportive measures make it possible for patients with severe injuries and physiologic impairment to survive what otherwise might have been lethal conditions. One of the major surgical consequences of extensive resuscitation efforts regards the condition of the…
Injury severity and the spectrum of injuries continue to evolve, resulting in greater and different challenges for the trauma surgeon. High-energy blunt trauma, as well as increased availability of military firearms with greater wounding capacity, have resulted in an increase…
The broad indications for blood transfusion are based on the fact that transfused blood is the best substitute for blood lost in acute haemorrhages. —L. Bruce Robertson, MD, Captain, Canadian Army Medical Corp, 1916 Salt water is for cooking pasta,…
Damage control resuscitation (DCR) has become a staple of modern surgical management of traumatic injuries. Hemorrhage secondary to trauma accounts for 40% of trauma fatalities and is the leading cause of preventable death in trauma. Research in military and civilian…
Exsanguination has been defined as an extreme form of hemorrhage with ongoing bleeding that, if not surgically controlled, will lead to death. Exsanguination is second only to neurologic injury among causes of fatality after trauma. Therefore, the speed by which…